Absorption: Well absorbed after oral administration. Distribution: Crosses the blood-brain barrier, crosses the placenta; small amounts enter breast milk. Metabolism and Excretion: Mostly metabolized by the liver (primarily by CYP2D6; the CYP2D6 enzyme system exhibits genetic polymorphism); ~7% of population may be poor metabolizers and may have significantly ↑ metoprolol concentrations and an ↑ risk of adverse effects. TIME/ACTION PROFILE (cardiovascular effects)When switching from immediate-release to extended-release product, the same total daily dose can be used PO: (Adults) Antihypertensive/antianginal– 25–100 mg/day as a single dose initially or 2 divided doses; may be ↑ q 7 days as needed up to 450 mg/day (immediate-release) or 400 mg/day (extended-release) (for angina, give in divided doses). MI– 25–50 mg (starting 15 min after last IV dose) q 6 hr for 48 hr, then 100 mg twice daily. Heart failure– 12.5–25 mg once daily (of extended-release), can be doubled every 2 wk up to 200 mg/day. Migraine prevention– 50–100 mg 2–4 times daily (unlabeled). IV: (Adults) MI– 5 mg q 2 min for 3 doses, followed by oral dosing. Tablets (tartrate): 25 mg, 50 mg, 100 mg Cost: Generic: All strengths $7.18/100Extended-release tablets (succinate; Toprol XL): 25 mg, 50 mg, 100 mg, 200 mg Cost: Generic: 25 mg $35.68/100, 50 mg $41.93/100, 100 mg $53.95/100, 200 mg $84.54/100Solution for injection: 1 mg/m LIn Combination with:hydrochlorothiazide (Dutoprol, Lopressor HCT). See combination drugs.metoprolol is a sample topic from the Davis's Drug Guide. This website contains 106190 drug listings as submitted to the Food and Drug Administration (FDA). At the present time, this Web site does not contain a complete listing of labels for approved prescription drugs. Posted: December 19, 2017 Drug Listing Certification The U. Food and Drug Administration is reminding the pharmaceutical industry of the December 31, 2017, deadline to update or certify their drug listings with FDA. This applies to drug listings that were not initially listed or updated during the current calendar year. This is the first deadline of the annual certification requirement under Part 207 of Title 21 of the Code of Federal Regulations. Companies must submit this information to FDA in electronic format. They may make a blanket "no changes" certification to indicate that their listing information is up to date in FDA's database.
Control of tachyarrhythmias, especially supraventricular tachyarrhythmias. The injection can be repeated at 5 minute intervals until a satisfactory response has been obtained. Injection to patients with a systolic blood pressure below 100 mm Hg should only be given with special care. The same dosage can also be used to control arrhythmias developing during anaesthesia. Injection should be initiated in a coronary care or similar unit when the patient's haemodynamic condition has stabilised. The second or third dose should not be given if the systolic blood pressure is 0.26 seconds, or if there is any aggravation of dyspnoea or cold sweating. Pain relief may also decrease the need for opiate analgesics. Initially up to 5 mg injected intravenously at a rate of 1-2 mg per minute. at induction is usually sufficient to prevent the development of arrhythmias during anaesthesia. every 2 minutes to a maximum of 15 mg total as determined by blood pressure and heart rate. Injection in acute myocardial infarction reduces infarct size and the incidence of ventricular fibrillation. Injection has been shown to reduce mortality when administered to patients with acute myocardial infarction. A total dose of 10-15 mg generally proves sufficient. Further injections of 2 mg may be given as required to a maximum overall dose of 10 mg. Oral therapy should commence 15 minutes after the last injection with 50 mg every 6 hours for 48 hours. Because of the risk of a pronounced drop of blood pressure, the I. Patients who fail to tolerate the full intravenous dose should be given half the suggested oral dose. Dose adjustment is normally not needed in patients suffering from liver cirrhosis because metoprolol has a low protein binding (5 – 10 %). However, in patients with severe hepatic dysfunction a reduction in dosage may be necessary. • Decompensated cardiac failure (pulmonary oedema, hypoperfusion or hypotension). Carvedilol and metoprolol are both beta blockers, but differ mainly in their selectivity of which beta-receptors they block. Carvedilol blocks both alpha and beta receptors and metoprolol is more cardioselective, that is, more selective to the heart. Depending on the manufacturers, the trade names of these medications differ from country to country. Both carvedilol and metoprolol are used to treat hypertension and cardiac conditions such as angina or congestive cardiac failure. They work by blocking beta receptors around the heart which prevents the action of adrenaline and noradrenaline, the fight or flight hormones. This slows the heart down and, in turn, reduces the pressure both on the heart and blood pressure. Unlike metoprolol, carvedilol also has some blocking action on alpha receptors, which causes widening of the blood vessels and less resistance, thus also lowering blood pressure.
Owing to the mechanism of metoprolol's competitive antago- nistic action on beta-adrenergic receptors β1-blocking, a reduction in HR was observed 27 in both groups A and B treated with 47.5 and 118.75 mg of metoprolol, respectively, from 1st-month through 12th-month follow-ups. In the management of angina pectoris, the mechanism of action of metoprolol is thought to be blockage of catecholamine-induced increases in heart rate.